The first few sessions will be an assessment. This may involve me asking questions about your life and troubles, or I might simply listen to what you have to say. Adolescents and children can find it difficult to express their thoughts and feelings and so I might help the process by asking them to draw something or to describe what they see in a picture.
Once I have a sense of the difficulty, I will share my thoughts and will make a recommendation. The assessment phase also allows you to consider whether you are comfortable working with me. This is important since therapy is based in openness and so your therapist should be someone with whom that you feel comfortable. I am happy to make a referral where the client might prefer to see someone else and I won’t take it personally.
If I recommend individual psychodynamic psychotherapy and you accept, we will establish how often to meet and set up regular meeting times, during office hours. Each meeting will last approximately 50min and regular attendance is vital to success. I provide a copy of the agreement, which I ask all my clients to look over and sign. This contains information regarding how we deal with practicalities such as payment, missed sessions, holidays and confidentiality.
The therapy sessions will differ from to the initial assessment sessions. How I approach therapy will depend on my assessment findings but I usually ask the client to begin the session by taking note of their thoughts and putting them into words. This should be as open as possible and without censorship; even if the thoughts seem irrelevant, silly, or unacceptable. This will probably feel uncomfortable at first since most people are used to being given advice or being led when dealing with professionals.
My task will be to listen very carefully, clarify, interpret, point out any associations that may not be obvious; and guide you to recognise and, if appropriate, challenge your patterns. I will refrain from disclosing personal information or making physical contact. This may feel cold and or unfriendly, but this stance has been shown to allow a person’s most important issues and emotions to surface and can reveal how they relate to others most clearly. Because the client and therapist are full partners in this process, we will both participate in making treatment decisions, including the decision to end therapy.